Provider Demographics
NPI:1780135160
Name:BELL, GINA (LCSW)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:BELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W SIXTH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2428
Mailing Address - Country:US
Mailing Address - Phone:484-445-4147
Mailing Address - Fax:484-445-4149
Practice Address - Street 1:100 W SIXTH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2428
Practice Address - Country:US
Practice Address - Phone:484-445-4147
Practice Address - Fax:484-445-4149
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0186441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical